Bulky Tip 8-9 Months After Rhinoplasty? (photo)

I had open rhinoplasty surgery about 8-9 months ago and I am rather unhappy with how the tip of my nose looks right now. Ideally it should be smaller and thinner. Judging by the pictures (if possible) is this due to swelling, scar tissue, thick skin or badly shaped cartilages. Note that before surgery I had a hump on the back of my nose but I did not have such a big tip. What are my options? Should I consider a revision rhinoplasty, or steroid injections, or should I be patient. Many thanks!

Doctor Answers 8

Unhappy with tip nine months post-rhinoplasty

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Be patient until you are at least one year or more from your surgery, as tip swelling can continue at this point. At one year post-op, I suggest having an experienced and board-certified rhinoplasty surgeon evaluate your nose if you are still unhappy with it. He/she may want to get the operative notes from your first surgery to see exactly what was done before deciding if a revision would be beneficial. In the meantime, I suggest you do pinching massage regularly, as it may help with the swelling, etc. 

Good luck!

Dr. A

Tip swelling?

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At 8-9 months tip swelling can still be an issue. You should give it at least a year. If the tip is mobile and soft, then  you are probably looking at the final size.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bulky tip 8-9 months after rhinoplasty?

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In general, the final result of rhinoplasty is not evident for 18-24 months following surgery. 70% of the swelling is resolved after the first 3 months, and the remainder goes down over time. Swelling can be influenced by the following: thickness of the patient's skin, whether the procedure was a revision, whether tip work was performed, and whether the procedure was open or closed. WIth an open rhinoplasty, you will have more swelling. The tip is usually the last to come around when you are healing. The nose continues to change throughout the healing process, and you should see improvements over time. It is too soon to be considering a revision, and I would give it a little more time and see how you continue to heal. Your surgeon should be able to answer any questions, as they know the extent of your surgery and exactly what was performed. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

8-9 months tip swelling

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The proper diagnosis must be made. thick scar, thick skin, excessive tip cartilages. From scarring, high concentration of steroid injections have worked great in my practice in Toronto, Canada at 8 months without complications. Each injection works over a 2 month period, but monthly injections may be necessary. It depends how the tip feels. Your surgeon can make the diagnosis 

David A. F. Ellis, MD
Toronto Facial Plastic Surgeon

Bulky Tip 8-9 Months After Rhinoplasty?

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Posting a before photo would help. Appears to me as if minimal tip changes were done. Therefore a revision would be the next step. 

Swelling after rhinoplasty

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I believe that you still have some swelling here that will continue to resolve. Wait another 4-6 months before considering any intervention.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Bulky Tip at 8 Months After Open Rhinoplasty

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      The swelling of the tip will last the longest of any part of the nose.  This will take at least a year.  Patients with thicker skin may need longer than 12 months to see tip swelling resolution.  Sometimes, steroid injections may be used, but they are not without risk.  Kenneth Hughes, MD Los Angeles, CA

Swelling of the tip of the nose after rhinoplasty

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Thanks very much for the photos and question. At 8-9 months following rhinoplasty, there is likely still some mild residual swelling in the tip and supratip (area above the tip). Careful examination of your nose in person would help to elucidate to what degree the width is related to swelling vs. the shape of your underlying cartilages. 

A Kenalog (steroid) injection could certainly be a reasonable option. You should check in with your surgeon to see if he or she feels this treatment would be appropriate. Patience is important as well, as the nose continues to become increasingly refined over the first 12 months (or longer) after rhinoplasty.

Best regards,

Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.